Ronald P D'Agostino DO PC

Organization Active NPI Family Medicine Physician · Lanse, MI

NPI 1548433360 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1548433360
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
5101008281 (MI)
Legal business name
RONALD P D'AGOSTINO DO PC
Practice address
108 W Eastern Ave
Lanse, MI 49946-1214
Phone
(906) 524-6366
Fax
(906) 524-6014
NPI assigned
Apr 12, 2008
Organization subpart
No

Authorized official

Name
Mr. Ronald P D'Agostino, DO
Title
President/Owner
Phone
(906) 524-7121

National Provider Directory

Locations

832 Sicotte St
Lanse, MI 49946
Phone (906) 225-5044

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 5101008281 MI Yes

Addresses

Primary practice location

108 W Eastern Ave
Lanse, MI 49946-1214

Mailing address

108 W Eastern Ave
Lanse, MI 49946-1214
Phone (906) 524-7121

Other identifiers

IdentifierTypeStateIssuer
4137523MedicaidMI
150700025OtherMIBCBS RENDERING ID

Other providers in Lanse, MI

All providers in Lanse, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.